title: Laparoscopic management of nonpalpable testis: new treatment strategy.
abstract: OBJECTIVE
  We established a new strategy for nonpalpable testis, including intra-abdominal testis, testicular nubbins, and intracanalicular testis, to correct these conditions by laparoscopic procedures.
  
  
  METHODS
  Of the 53 boys (mean age, 24.5 months), nonpalpable testis was on the right side in 13, on the left in 34, and bilateral in 6. Three boys with nonpalpable testis involved contralateral palpable undescended testis. We applied only laparoscopic treatment without open inguinal incision for all cases. After laparoscopic orchiopexy and orchiectomy, we performed subsequent laparoscopic inguinal ring and/or peritoneal defect closure to prevent postoperative inguinal hernia formation, and concurrent laparoscopic repair for cases of contralateral undescended testes and open processus vaginalis under the same anesthesia.
  
  
  RESULTS
  All boys underwent laparoscopic treatment immediately after laparoscopic evaluation. We performed laparoscopic orchiopexy for 22 cases with intra-abdominal testes. Twenty-seven boys underwent laparoscopic groin exploration, and 24 underwent subsequent laparoscopic orchiectomy for testicular nubbins, and 3 underwent subsequent laparoscopic orchiopexy for intracanalicular testes. In two boys with testicular nubbin, an open processus vaginalis was present. Forty-nine boys underwent laparoscopic inguinal ring and/or peritoneal defect closure after orchiopexy or orchiectomy to prevent inguinal hernia formation or hydrocele testis. Concurrent laparoscopic contralateral inguinal closure was performed for two cases with opened contralateral processus vaginalis.
  
  
  CONCLUSIONS
  Our new strategy is useful because all patients with nonpalpable testis could be treated successfully by only laparoscopic management, avoiding open inguinal incision, preventing inguinal hernia formation, and enabling the concurrent repair of contralateral undescended testis and open processus vaginalis.
authors.affiliation: Department of Nephro-urology, Nagoya City University Graduate School of Medical Sciences, Mizuho-ku, Nagoya, Japan. ykojima@med.nagoya-cu.ac.jp
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Kojima
authors.forename: Kentaro
authors.initials: K
authors.lastname: Mizuno
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Kamisawa
authors.forename: Toshiki
authors.initials: T
authors.lastname: Kato
authors.forename: Kenjiro
authors.initials: K
authors.lastname: Kohri
authors.forename: Yutaro
authors.initials: Y
authors.lastname: Hayashi
mesh_terms: D002675:Child, Preschool; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D010173:Palpation; D011182:Postoperative Care; D011300:Preoperative Care; D013737:Testis / Q000002:abnormalities* / Q000601:surgery*